hospital_name last_updated_on version hospital_location hospital_address license_number|TN "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." Delta Specialty Hospital 5/31/2024 2.0.0 "Memphis, TN" 3000 Getwell Road license_ 106 |TN TRUE description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_AETNA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_AETNA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_AETNA]|[plan_HMO/PPO] standard_charge|[payer_AETNA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_AETNA]|[Plan_HMO/PPO] standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_AETNA MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_AMBETTER]|[plan_COMMERCIAL]|negotiated_dollar standard_charge|[payer_AMBETTER]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_AMBETTER]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_AMBETTER]|[plan_COMMERCIAL] standard_charge|[payer_AMBETTER]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_AMBETTER]|[Plan_COMMERCIAL] standard_charge|[payer_AMERIGROUP]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_AMERIGROUP]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_AMERIGROUP]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_AMERIGROUP]|[plan_MANAGED MEDICAID] standard_charge|[payer_AMERIGROUP]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_AMERIGROUP]|[Plan_MANAGED MEDICAID] standard_charge|[payer_AMERIVANTAGE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_AMERIVANTAGE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_AMERIVANTAGE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_AMERIVANTAGE]|[plan_MANAGED MEDICARE] standard_charge|[payer_AMERIVANTAGE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_AMERIVANTAGE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_BC FEDERAL]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BC FEDERAL]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BC FEDERAL]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BC FEDERAL]|[plan_BLUE CROSS] standard_charge|[payer_BC FEDERAL]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BC FEDERAL]|[Plan_BLUE CROSS] standard_charge|[payer_BC OF TN]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BC OF TN]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BC OF TN]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BC OF TN]|[plan_BLUE CROSS] standard_charge|[payer_BC OF TN]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BC OF TN]|[Plan_BLUE CROSS] standard_charge|[payer_BC OOS]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BC OOS]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BC OOS]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BC OOS]|[plan_BLUE CROSS] standard_charge|[payer_BC OOS]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BC OOS]|[Plan_BLUE CROSS] standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_BEACON HEALTH]|[plan_HMO/PPO] standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_BEACON HEALTH]|[Plan_HMO/PPO] standard_charge|[payer_BLUE ADVANTAGE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_BLUE ADVANTAGE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_BLUE ADVANTAGE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_BLUE ADVANTAGE]|[plan_MANAGED MEDICARE] standard_charge|[payer_BLUE ADVANTAGE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_BLUE ADVANTAGE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_BLUECARE PLUS]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_BLUECARE PLUS]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_BLUECARE PLUS]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_BLUECARE PLUS]|[plan_MANAGED MEDICARE] standard_charge|[payer_BLUECARE PLUS]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_BLUECARE PLUS]|[Plan_MANAGED MEDICARE] standard_charge|[payer_BLUECARE SELECT]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_BLUECARE SELECT]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_BLUECARE SELECT]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_BLUECARE SELECT]|[plan_MANAGED MEDICAID] standard_charge|[payer_BLUECARE SELECT]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_BLUECARE SELECT]|[Plan_MANAGED MEDICAID] standard_charge|[payer_BLUECARE TNCARE]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_BLUECARE TNCARE]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_BLUECARE TNCARE]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_BLUECARE TNCARE]|[plan_MANAGED MEDICAID] standard_charge|[payer_BLUECARE TNCARE]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_BLUECARE TNCARE]|[Plan_MANAGED MEDICAID] standard_charge|[payer_BRIGHT HEALTH PLAN]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_BRIGHT HEALTH PLAN]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_BRIGHT HEALTH PLAN]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_BRIGHT HEALTH PLAN]|[plan_HMO/PPO] standard_charge|[payer_BRIGHT HEALTH PLAN]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_BRIGHT HEALTH PLAN]|[Plan_HMO/PPO] standard_charge|[payer_CIGNA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_CIGNA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_CIGNA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CIGNA]|[plan_HMO/PPO] standard_charge|[payer_CIGNA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_CIGNA]|[Plan_HMO/PPO] standard_charge|[payer_GREAT WEST LIFE]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_GREAT WEST LIFE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_GREAT WEST LIFE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_GREAT WEST LIFE]|[plan_HMO/PPO] standard_charge|[payer_GREAT WEST LIFE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_GREAT WEST LIFE]|[Plan_HMO/PPO] standard_charge|[payer_HEALTHSPRING]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_HEALTHSPRING]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_HEALTHSPRING]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_HEALTHSPRING]|[plan_MANAGED MEDICARE] standard_charge|[payer_HEALTHSPRING]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_HEALTHSPRING]|[Plan_MANAGED MEDICARE] standard_charge|[payer_HUMANA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HUMANA]|[plan_HMO/PPO] standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_HUMANA]|[Plan_HMO/PPO] standard_charge|[payer_MEDICAID ARK]|[plan_MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_MEDICAID ARK]|[plan_MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_MEDICAID ARK]|[plan_MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_MEDICAID ARK]|[plan_MEDICAID: OUT OF STATE] standard_charge|[payer_MEDICAID ARK]|[plan_MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_MEDICAID ARK]|[Plan_MEDICAID: OUT OF STATE] standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MISC HMO/PPO]|[plan_HMO/PPO] standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MISC HMO/PPO]|[Plan_HMO/PPO] standard_charge|[payer_MISC MGD MCAID]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_MISC MGD MCAID]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_MISC MGD MCAID]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_MISC MGD MCAID]|[plan_MANAGED MEDICAID] standard_charge|[payer_MISC MGD MCAID]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_MISC MGD MCAID]|[Plan_MANAGED MEDICAID] standard_charge|[payer_NAPHCARE INC]|[plan_LOCAL GOVT]|negotiated_dollar standard_charge|[payer_NAPHCARE INC]|[plan_LOCAL GOVT] |negotiated_percentage standard_charge|[payer_NAPHCARE INC]|[plan_LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_NAPHCARE INC]|[plan_LOCAL GOVT] standard_charge|[payer_NAPHCARE INC]|[plan_LOCAL GOVT] |methodology additional_payer_notes |[payer_NAPHCARE INC]|[Plan_LOCAL GOVT] standard_charge|[payer_NAPHCARE INC MEDICAL]|[plan_LOCAL GOVT]|negotiated_dollar standard_charge|[payer_NAPHCARE INC MEDICAL]|[plan_LOCAL GOVT] |negotiated_percentage standard_charge|[payer_NAPHCARE INC MEDICAL]|[plan_LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_NAPHCARE INC MEDICAL]|[plan_LOCAL GOVT] standard_charge|[payer_NAPHCARE INC MEDICAL]|[plan_LOCAL GOVT] |methodology additional_payer_notes |[payer_NAPHCARE INC MEDICAL]|[Plan_LOCAL GOVT] standard_charge|[payer_UBH]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_UBH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UBH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UBH]|[plan_HMO/PPO] standard_charge|[payer_UBH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UBH]|[Plan_HMO/PPO] standard_charge|[payer_UBH MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_UBH MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_UBH MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_UBH MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_UBH MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_UBH MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_UHC MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_UHC MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_UHC TENNCARE]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_UHC TENNCARE]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_UHC TENNCARE]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_UHC TENNCARE]|[plan_MANAGED MEDICAID] standard_charge|[payer_UHC TENNCARE]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_UHC TENNCARE]|[Plan_MANAGED MEDICAID] standard_charge|[payer_UMR]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_UMR]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UMR]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UMR]|[plan_HMO/PPO] standard_charge|[payer_UMR]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UMR]|[Plan_HMO/PPO] standard_charge|[payer_VA COMM CARE PSYCH]|[plan_VETERANS ADMIN]|negotiated_dollar standard_charge|[payer_VA COMM CARE PSYCH]|[plan_VETERANS ADMIN] |negotiated_percentage standard_charge|[payer_VA COMM CARE PSYCH]|[plan_VETERANS ADMIN] |negotiated_algorithm estimated_amount|[payer_VA COMM CARE PSYCH]|[plan_VETERANS ADMIN] standard_charge|[payer_VA COMM CARE PSYCH]|[plan_VETERANS ADMIN] |methodology additional_payer_notes |[payer_VA COMM CARE PSYCH]|[Plan_VETERANS ADMIN] additional_generic_notes ROOM AND BOARD-M/S-SEMI PRIV 121 RC facility inpatient 1785 950 750 750 750 per diem ROOM AND BOARD BHU PSYCH SEMI P 124 RC facility inpatient 1785 950 494 1785 950 per diem 950 per diem 675 per diem 950 per diem 950 per diem 950 per diem 565 per diem 950 per diem 950 per diem 565 per diem 610 per diem 1461 per diem 840 per diem 840 per diem 1000 per diem 494 per diem 1785 per diem 1785 per diem 750 per diem 750 per diem 817 per diem 615 per diem 817 per diem ROOM AND BOARD PSYCH 124 RC facility inpatient 1785 950 494 1785 950 per diem 950 per diem 675 per diem 950 per diem 950 per diem 950 per diem 565 per diem 950 per diem 950 per diem 565 per diem 610 per diem 1461 per diem 840 per diem 840 per diem 1000 per diem 494 per diem 1785 per diem 1785 per diem 750 per diem 750 per diem 817 per diem 615 per diem 817 per diem ROOM AND BOARD BHU DETOX SEMI P 126 RC facility inpatient 1785 950 494 1785 950 per diem 950 per diem 675 per diem 950 per diem 950 per diem 950 per diem 565 per diem 950 per diem 950 per diem 565 per diem 610 per diem 1234 per diem 840 per diem 840 per diem 1000 per diem 494 per diem 1785 per diem 1785 per diem 750 per diem 817 per diem 615 per diem 817 per diem ELECTROCONVULSIVE 901 RC facility outpatient 1205 350 693 350 per diem 350 per diem 425 per diem 693 per diem INTENSIVE OUTPATIENT 905 RC facility outpatient 300 150 80 300 250 per diem 80 per diem 205 per diem 275 per diem 275 per diem 275 per diem 130 per diem 275 per diem 275 per diem 130 per diem 135 per diem 160 per diem 160 per diem 205 per diem 300 per diem 180 per diem 180 per diem 200 per diem 85 per diem 180 per diem 263 per diem MH INTENSIVE OUTPATIENT PROGRAM 905 RC facility outpatient 300 150 80 300 250 per diem 80 per diem 205 per diem 275 per diem 275 per diem 275 per diem 130 per diem 275 per diem 275 per diem 130 per diem 135 per diem 160 per diem 160 per diem 205 per diem 300 per diem 180 per diem 180 per diem 200 per diem 85 per diem 180 per diem 263 per diem SA INTENSIVE OUTPATIENT PROGRAM 906 RC facility outpatient 300 150 85 352 250 per diem 100 per diem 205 per diem 275 per diem 275 per diem 275 per diem 130 per diem 275 per diem 275 per diem 130 per diem 135 per diem 352 per diem 160 per diem 160 per diem 205 per diem 300 per diem 180 per diem 180 per diem 200 per diem 85 per diem 180 per diem MH PARTIAL HOSPITAL PROGRAM HALF DAY 912 RC facility outpatient 600 250 165 600 415 per diem 250 per diem 238 per diem 525 per diem 525 per diem 525 per diem 240 per diem 525 per diem 525 per diem 240 per diem 240 per diem 460 per diem 305 per diem 305 per diem 238 per diem 400 per diem 600 per diem 252 per diem 252 per diem 272 per diem 165 per diem 252 per diem SA PARTIAL HOS PROG 912 RC facility outpatient 600 250 165 600 415 per diem 250 per diem 238 per diem 525 per diem 525 per diem 525 per diem 240 per diem 525 per diem 525 per diem 240 per diem 240 per diem 460 per diem 305 per diem 305 per diem 238 per diem 400 per diem 600 per diem 252 per diem 252 per diem 272 per diem 165 per diem 252 per diem MH PARTIAL HOSPITAL PROGRAM FULL DAY 913 RC facility outpatient 600 250 165 600 415 per diem 250 per diem 238 per diem 525 per diem 525 per diem 525 per diem 240 per diem 525 per diem 525 per diem 240 per diem 240 per diem 460 per diem 305 per diem 305 per diem 238 per diem 400 per diem 600 per diem 252 per diem 252 per diem 272 per diem 165 per diem 252 per diem PARTIAL HOSP DAILY 913 RC facility outpatient 600 250 165 600 415 per diem 250 per diem 238 per diem 525 per diem 525 per diem 525 per diem 240 per diem 525 per diem 525 per diem 240 per diem 240 per diem 460 per diem 305 per diem 305 per diem 238 per diem 400 per diem 600 per diem 252 per diem 252 per diem 272 per diem 165 per diem 252 per diem SA PARTIAL HOSPITAL PROGRAM FULL DAY 913 RC facility outpatient 600 250 165 600 415 per diem 250 per diem 238 per diem 525 per diem 525 per diem 525 per diem 240 per diem 525 per diem 525 per diem 240 per diem 240 per diem 460 per diem 305 per diem 305 per diem 238 per diem 400 per diem 600 per diem 252 per diem 252 per diem 272 per diem 165 per diem 252 per diem INITIAL HOSPITAL CARE (50 MIN) 99222 RC facility outpatient 200 67 176 176 fee schedule 106 fee schedule 121 fee schedule 70 fee schedule 70 fee schedule 90 fee schedule 67 fee schedule INITIAL HOSPITAL CARE (70 MIN) 99223 RC facility outpatient 290 99 157 157 fee schedule 99 fee schedule 99 fee schedule 99 fee schedule SUBSEQ CARE (15 MIN) 99231 RC facility outpatient 90 20 20 20 fee schedule SUBSEQ CARE (25 MIN) 99232 RC facility outpatient 100 34 87 87 fee schedule 56 fee schedule 59 fee schedule 34 fee schedule 34 fee schedule 74 fee schedule 37 fee schedule SUBSEQ CARE (35 MIN) 99233 RC facility outpatient 150 35 93 93 fee schedule 56 fee schedule 60 fee schedule 57 fee schedule 57 fee schedule 35 fee schedule DISCHARGE DAY MGMT <30 MIN 99238 RC facility outpatient 150 35 93 93 fee schedule 56 fee schedule 60 fee schedule 57 fee schedule 57 fee schedule 35 fee schedule